THE APOLIPOPROTEIN-E EPSILON-4 ALLELE IS NOT ASSOCIATED WITH PSYCHIATRIC-SYMPTOMS OR EXTRAPYRAMIDAL SIGNS IN PROBABLE ALZHEIMERS-DISEASE

Article The objective of our study was to examine the relationship bet ween the presence of the apolipoprotein E (ape E) E4 allele? psychiatr ic symptoms, and extrapyramidal signs (EPS) in probable Alzheimer's di sease (AD). The apo E E4 allele modifies the risk and age at onset of AD. However, it still needs to be determined whether it is a marker fo r specific clinical subgroups. The frequency of clinical signs and sym ptoms was examined in 194 AD patients with the apo E E3/3 (N = 79), E3 /4 (N = 96). and E4/4 (N = 19) genotypes participating in a longitudin al study of dementia. Each patient was assessed with semistructured ps ychiatric and neurologic examinations. Patients with the E4/4 genotype had an earlier age at onset of dementia (p = 0.03). However, no indiv idual psychiatric symptom or neurologic sign was associated with the p resence of the apo E E4 allele, including major depression (odds ratio [OR], 1.14; CI, 0.50 to 2.45; p = 0.78), psychosis (e.g., delusions a nd hallucinations) (OR, 0.66, CI, 0.35 to 1.25; p = 0.20), and EPS (in neuroleptic-free patients) (ORI 0.82, CI, 0.45 to 1.49; p = 0.52), af ter controlling by age at onset, duration of the symptoms, education, and severity of dementia. The presence of the apo E E4 allele has limi ted utility in the characterization of neurologic and psychiatric subg roups in probable AD patients. The apo E E4/4 genotype appears to be r elated to age at onset of AD, consistent with previous findings.